4 ms·

Unfortunately, that's not the case in all areas where Lyme is prevalent. On top of that, the standard Lyme test is not very reliable. Living in New Jersey (fill

Unfortunately, that's not the case in all areas where Lyme is prevalent. On top of that, the standard Lyme test is not very reliable. Living in New Jersey (filled with deer, mice, and ticks) you would think that doctors would be more aware. But it took several different doctors, emergency visits, hospitalizations, and, yes, a negative Lyme test before my wife was finally diagnosed. The standard reply in the hospital was that even though they had no clue what was wrong with my wife, they were certain that it wasn't Lyme. And since insurance doesn't cover the Igenix tests, we had to pay the $300+ out of pocket.

tomkinstinch 11y ago
Like you said, the standard Lyme test is not very reliable. Even if laboratory tests are ordered, labs are still using immunoassays for confirmation of Lyme (ELISA, then a Western Blot), which have relatively poor sensitivity (~70% or lower[1]) due to low serum concentration of Borrelia or possible absence of antibodies—so they can miss one in four true-positive cases. The newer PCR-based assays have much better sensitivity (>70%, maybe closer to 90%[2]), but the assays are not yet in widespread use, are still being proven, and thus are seen only as adjuncts to immunoassays that can provide further evidence of Lyme. It can also take a couple weeks from when the bullseye rash appears (or when the tick bite occurs) for serology to test positive, again due to the Borrelia/antibody concentration being below the limit of detection. Samples tested are also usually blood, which may not be as good as CSF. It's a tricky bug to diagnose in the laboratory, which is why it comes down to the discretion of the clinician and the doctor's knowledge of the patient and his or her history. 1. http://www.igenex.com/files/should_know.pdf http://www.igenex.com/files/should_know.pdf 2. Laboratory Diagnostic Testing for Borrelia burgdorferi Infection, Lyme Disease: An Evidence-based Approach: http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_JohnsonB.pdf http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_Johnso...

tomkinstinch 11y ago

Like you said, the standard Lyme test is not very reliable. Even if laboratory tests are ordered, labs are still using immunoassays for confirmation of Lyme (ELISA, then a Western Blot), which have relatively poor sensitivity (~70% or lower[1]) due to low serum concentration of Borrelia or possible absence of antibodies—so they can miss one in four true-positive cases. The newer PCR-based assays have much better sensitivity (>70%, maybe closer to 90%[2]), but the assays are not yet in widespread use, are still being proven, and thus are seen only as adjuncts to immunoassays that can provide further evidence of Lyme. It can also take a couple weeks from when the bullseye rash appears (or when the tick bite occurs) for serology to test positive, again due to the Borrelia/antibody concentration being below the limit of detection. Samples tested are also usually blood, which may not be as good as CSF. It's a tricky bug to diagnose in the laboratory, which is why it comes down to the discretion of the clinician and the doctor's knowledge of the patient and his or her history. 1. http://www.igenex.com/files/should_know.pdf http://www.igenex.com/files/should_know.pdf 2. Laboratory Diagnostic Testing for Borrelia burgdorferi Infection, Lyme Disease: An Evidence-based Approach: http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_JohnsonB.pdf http://www.cdc.gov/lyme/resources/Halperin_2012_Chap4_Johnso...